Classification of Fractures
Comminuted, when there is extensive splintering of the bone adjoining the fracture or one of the fragments.
Impacted, when the fragments are driven into each other. This variety usually occurs in the neck of the femur.
Compression, or Crushing Fractures, when the broken bones are compressed or crushed; this variety usually occurs in the tarsal bones. The spongy portion and cortical layer are both crushed. In some cases there is a perfect pulpification of these bones. This condition occurs after falls from a height upon the sole of the foot.
Location of Fracture
In the Diaphysis of a Bone. Breaks in the diaphysis of a bone are spoken of as fractures of the shaft, and to be still more exact, it is stated whether of the upper, middle, or lower third.
At the Ends of Bones. Fractures occurring at the ends of bones receive the name of the part which the line of fracture transverses; for example, fractures of the neck of a bone, of a tuberosity, of a process, of a condyle, etc.
There are two forms of fracture that require special mention in connection with their location. These are epiphyseal separations and articular fractures.
Epiphyseal Separations. The union of the epiphysis to the diaphysis commences during puberty, hence these fractures are less common in childhood than after the ages of eleven or twelve. As a rule, they can only occur before the twentieth year. The periosteum is more resisting and tougher during the early years of life than later on.